Transfusion in cardiac surgery is hard to avoid and its negative effect on patient outcomes has been proved. Notably, patient blood management (PBM), as an evidence‑based, patient‑centered, systematic approach, can reduce unnecessary exposure to blood products and improve patient prognosis. This review summarizes the research progress on perioperative blood management during cardiac surgery, covering the preoperative, intraoperative, and postoperative phases, in order to provide guidance for clinical practitioners. The preoperative phase focuses on the assessment of high‑risk bleeding patients and anemia management. Optimization of intraoperative blood management strategies encompasses using minimally invasive techniques, retrograde autologous priming, autologous blood reinfusion, concentrated clotting factors, antifibrinolytics, and viscoelastic coagulation tests. Furthermore, a restrictive transfusion strategy is adopted after surgery.